Doctors across the UK have overwhelmingly voted in favour of the new GP contract, ending months of uncertainty about the reform of general practice.

Eight out of ten GPs backed the deal, which is seen as crucial to the Government's plans for modernising primary care and increasing the number of GPs.

Doctors will now see an average pay rise of 26% over the next three years, from £65,000 to £82,000, and will be able to opt out of providing extra services, such as out-of-hours care, minor surgery and immunisations.

New Health Secretary Dr John Reid expressed his delight with the result, relieved at not having a second medical rebellion on his hands, after hospital consultants recently approved industrial action over the Government's refusal to renegotiate their troubled contract.

"Patients, doctors and the wider NHS will benefit from these reforms," said Dr Reid. "This is a very positive development and a big step forward in modernising the NHS."

Of the 45,750 ballot papers sent out, 70% were returned, with 79.4% in favour and 20.6% against the contract.

But a survey of local medical committees by The Guardian just days before the voting deadline revealed that many doctors have felt coerced into voting for the contract, following the Government's warning that a 'no' vote would lead to many of the contract benefits being jeopardised.

These include a back-dated 11% pay rise for this year, improved pensions and the option to opt-out of providing out-of-hours care.

The turmoil surrounding the state of the consultants' contract is understood to also have played a large part in persuading GPs to vote in favour.

Charles Simenoff, Chairman of Manchester Local Medical Committee, said doctors were angered by the BMA, which they felt had failed to secure better terms and conditions.

"We feel extremely disappointed and annoyed with the BMA. If it sees a 'yes' vote as a personal endorsement it would be very much mistaken."

The BMA decided to press ahead with the ballot despite calls from LMC leaders to delay the vote by six months. But the Government warned such a delay would lead to the contract failing to make it into this year Health and Social Care Bill.

The contract was initially unveiled in February and GPs were due to be balloted earlier in the year, but a flaw was discovered whereby as many as 70% of doctors would lose income under the new Carr-Hill funding formula, which directly links pay to the level of services offered.

A Minimum Practice Income Guarantee (MPIG) was hastily negotiated by the BMA and the NHS Confederation, but many GPs remain unconvinced by the pay structure offered by the complex formula.

Dr John Chisholm, Chairman of the BMA's General Practice Committee, welcomed the result, saying it signalled  'a new era for general practice,' but acknowledged the fact that many GPs remained unhappy.

"While I am delighted by the overwhelmingly supportive vote in favour of the new contract, I am in no way complacent," he said. "The negotiations have been difficult and there are GPs who do not have the confidence in parts of the new contract."

"The negotiating team is in no doubt what their concerns are and there is much work to be done during the implementation phase of the contract. This will begin immediately."

The NHS Alliance has repeatedly expressed concerns about the funding formula but nevertheless welcomed the vote, saying it "secured the future" for general practice. But it added that it represents a "huge challenge" to primary care organisations, especially given the delay in the ballot.

While parts of the contract must now be incorporated into the Government Health and Social Care bill and will come into force next April, certain aspects, including this year 11% pay rise, will be implemented straight away.

pharmafocus@pharmafile.co.uk